Community-associated methicillin-resistant Staphylococcus aureus, Canada - PubMed (original) (raw)

Community-associated methicillin-resistant Staphylococcus aureus, Canada

Michael R Mulvey et al. Emerg Infect Dis. 2005 Jun.

Abstract

A total of 184 methicillin-resistant Staphylococcus aureus (MRSA) strains were collected from patients who sought treatment primarily for skin and soft tissue infections from January 1, 1999, to March 31, 2002, in east-central Saskatchewan, Canada. Molecular subtyping analysis using pulsed-field gel electrophoresis showed 2 major clusters. Cluster A (n = 55) was composed of a multidrug-resistant MRSA strain associated with a long-term care facility and was similar to the previously reported nosocomial Canadian epidemic strain labeled CMRSA-2. Cluster B (n = 125) was associated with cases identified at community health centers and was indistinguishable from a community-associated (CA)-MRSA strain identified previously in the United States (USA400). Cluster B remained susceptible to a number of classes of antimicrobial agents and harbored the lukF-PV and lukS-PV toxin genes. Over 50% of both clonal groups displayed high-level resistance to mupirocin. This is the first report of the USA400 strain harboring the lukF-PV and lukS-PV toxin genes in Canada.

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Figures

Figure 1

Figure 1

Epidemiologic curve showing the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in central-eastern Saskatchewan. A) Number of nonrepeat cases over the length of study; solid bars, cases identified in a long-term care facility; gray bars, cases identified in community health centers. B) Same data as (A), with solid bars representing isolates of clone A and gray bars showing isolates of clone B.

Figure 2

Figure 2

A) Pulsed-field gel electrophoresis (PFGE) fingerprint of USA400 and PFGE pattern B1. B) Dendrogram showing relationship of the unique fingerprints, along with the PFGE type designation (11) and other molecular characteristics of each subtype. CDN, Canadian Diseases Network; MLST, multilocus sequence typing; SCC, staphylococcal chromosome cassette.

Figure 3

Figure 3

Age distribution of patients with cases caused by each clonal type A (white bars) or type B (black bars).

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